Predicting long-term functional limitations among back pain patients in primary care settings

Clermont E. Dionne, Thomas D. Koepsell, Michael Von Korff, Richard (Rick) Deyo, William E. Barlow, Harvey Checkoway

Research output: Contribution to journalArticle

146 Citations (Scopus)

Abstract

To identify predictors of back-related long-term functional limitations, 1213 adult enrollees of a Health Maintenance Organization (HMO) in Washington state were interviewed about a month after a consultation for back pain in a primary care setting in 1989-1990, and followed each year thereafter. Out of 100 factors documented at the one-month assessment, measures of somatization, depression, functional limitations, and pain were the strongest predictors of two-year modified Roland-Morris score among a random subsample of 569 subjects. A multiple regression model containing the Symptom Checklist Depression and Somatization scores, the one-month modified Roland-Morris score and the number of pain days in the past six months explained about 30% of the variance in the outcome. Using recursive partitioning, a very simple model was developed to identify patients at high risk of sustaining long-term significant functional limitations. The regression model and the recursive partitioning model were successfully tested in a fresh sample of patients (n = 644). Clinical application of the recursive partitioning model and methodological aspects of this study are discussed.

Original languageEnglish (US)
Pages (from-to)31-43
Number of pages13
JournalJournal of Clinical Epidemiology
Volume50
Issue number1
DOIs
StatePublished - Jan 1997
Externally publishedYes

Fingerprint

Back Pain
Primary Health Care
Depression
Pain
Health Maintenance Organizations
Checklist
Referral and Consultation

Keywords

  • Back pain
  • Functional limitations
  • Outcome prediction
  • Recursive partitioning

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Predicting long-term functional limitations among back pain patients in primary care settings. / Dionne, Clermont E.; Koepsell, Thomas D.; Von Korff, Michael; Deyo, Richard (Rick); Barlow, William E.; Checkoway, Harvey.

In: Journal of Clinical Epidemiology, Vol. 50, No. 1, 01.1997, p. 31-43.

Research output: Contribution to journalArticle

Dionne, Clermont E. ; Koepsell, Thomas D. ; Von Korff, Michael ; Deyo, Richard (Rick) ; Barlow, William E. ; Checkoway, Harvey. / Predicting long-term functional limitations among back pain patients in primary care settings. In: Journal of Clinical Epidemiology. 1997 ; Vol. 50, No. 1. pp. 31-43.
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